| Harrison Dental | |
|
1675 W Hill Rd Boise ID 83702-0982 | |
| (208) 342-3695 | |
| (208) 342-4065 |
| Full Name | Harrison Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1675 W Hill Rd, Boise, Idaho |
| Authorized Official Name and Position | Errol C Fife (OWNER PRESIDENT) |
| Authorized Official Contact | 2083423695 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Harrison Dental 1675 W Hill Rd Boise ID 83702-0982 Ph: (208) 342-3695 | Harrison Dental 1675 W Hill Rd Boise ID 83702-0982 Ph: (208) 342-3695 |
| NPI Number | 1972612489 |
|---|---|
| Provider Enumeration Date | 08/29/2006 |
| Last Update Date | 07/02/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972612489 | NPI | - | NPPES |
| 002562000 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D 1587 (Idaho) | Primary |
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